Clinical severity and prognosis of hand eczema
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Clinical severity and prognosis of hand eczema. / Hald, M; Agner, T; Blands, J; Veien, N K; Laurberg, G; Avnstorp, C; Menné, T; Kaaber, K; Kristensen, B; Kristensen, O; Andersen, K E; Paulsen, E; Thormann, J; Sommerlund, M; Nielsen, N H; Johansen, J D.
I: British Journal of Dermatology, Bind 160, Nr. 6, 2009, s. 1229-36.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Clinical severity and prognosis of hand eczema
AU - Hald, M
AU - Agner, T
AU - Blands, J
AU - Veien, N K
AU - Laurberg, G
AU - Avnstorp, C
AU - Menné, T
AU - Kaaber, K
AU - Kristensen, B
AU - Kristensen, O
AU - Andersen, K E
AU - Paulsen, E
AU - Thormann, J
AU - Sommerlund, M
AU - Nielsen, N H
AU - Johansen, J D
N1 - Keywords: Adolescent; Adult; Aged; Aged, 80 and over; Cohort Studies; Eczema; Female; Follow-Up Studies; Hand Dermatoses; Humans; Male; Middle Aged; Photography; Prognosis; Prospective Studies; Questionnaires; Regression Analysis; Severity of Illness Index; Young Adult
PY - 2009
Y1 - 2009
N2 - BACKGROUND: Hand eczema (HE) is a frequent, long-lasting disease with both personal and societal repercussions. Consequently, more information is needed on factors that maintain symptoms. OBJECTIVES: In this study, patients with HE were followed for 6 months from the first visit to a dermatologist to identify factors associated with severe disease and a poor prognosis. METHODS: Study participants were 799 patients with HE from nine dermatological clinics in Denmark. Severity assessment of the HE was done at baseline and at the 6-month follow-up using the Hand Eczema Severity Index (HECSI) and by patients using a self-administered photographic guide. Additional information was obtained from a baseline questionnaire. RESULTS: At baseline, 60.3% assessed their HE as moderate to very severe using the self-administered photographic guide compared with 36.1% at follow-up. The mean HECSI value decreased from 19.9 points at baseline to 11.2 points at follow-up (P < 0.001). In a multivariable logistic regression analysis, statistically significant associations with severe HE at baseline were older age (P < 0.001), atopic dermatitis (P = 0.01) and > or = 1 positive patch test (P < 0.001). Being an unskilled worker was a predictor for a poor prognosis at follow-up (P = 0.04), and the presence of frequent symptoms during the previous 12 months was associated with severe initial disease (P = 0.02) and a poor prognosis (P = 0.04). CONCLUSIONS: Overall, the disease had improved 6 months after the dermatological examination: nevertheless, many patients continued to have significant symptoms. Dermatologists should pay special attention to patients with frequent eruptions and to unskilled workers.
AB - BACKGROUND: Hand eczema (HE) is a frequent, long-lasting disease with both personal and societal repercussions. Consequently, more information is needed on factors that maintain symptoms. OBJECTIVES: In this study, patients with HE were followed for 6 months from the first visit to a dermatologist to identify factors associated with severe disease and a poor prognosis. METHODS: Study participants were 799 patients with HE from nine dermatological clinics in Denmark. Severity assessment of the HE was done at baseline and at the 6-month follow-up using the Hand Eczema Severity Index (HECSI) and by patients using a self-administered photographic guide. Additional information was obtained from a baseline questionnaire. RESULTS: At baseline, 60.3% assessed their HE as moderate to very severe using the self-administered photographic guide compared with 36.1% at follow-up. The mean HECSI value decreased from 19.9 points at baseline to 11.2 points at follow-up (P < 0.001). In a multivariable logistic regression analysis, statistically significant associations with severe HE at baseline were older age (P < 0.001), atopic dermatitis (P = 0.01) and > or = 1 positive patch test (P < 0.001). Being an unskilled worker was a predictor for a poor prognosis at follow-up (P = 0.04), and the presence of frequent symptoms during the previous 12 months was associated with severe initial disease (P = 0.02) and a poor prognosis (P = 0.04). CONCLUSIONS: Overall, the disease had improved 6 months after the dermatological examination: nevertheless, many patients continued to have significant symptoms. Dermatologists should pay special attention to patients with frequent eruptions and to unskilled workers.
U2 - 10.1111/j.1365-2133.2009.09139.x
DO - 10.1111/j.1365-2133.2009.09139.x
M3 - Journal article
C2 - 19416249
VL - 160
SP - 1229
EP - 1236
JO - British Journal of Dermatology
JF - British Journal of Dermatology
SN - 0007-0963
IS - 6
ER -
ID: 20319794